The Oral Contraceptive Pill: Take Two
I’ve written an article on the Oral Contraceptive Pill (OCP) before (you can read it here) so I don’t intend on this being a repeat. However, after writing an instagram post that the OCP can cause nutrient deficiencies, and having HUNDREDS of women reach out to me wanting more information, it’s quite clear that this is a sought after topic. It’s clear that people want to be informed. It’s clear that people are not being informed.
As I also mentioned in my first article, this is not about shaming you for your medication choices. Not I, your doctor, best mate, or cat has the right to tell you that you should choose a natural alternative of birth control, or pain management, or whatever the reason you are taking the OCP. You do you, because no-one understands the position you are in but you. I know all too well what it’s like to be offered a solution and wanting more than anything to take it, regardless of whether it is the correct one in the long run. In times of desperation or even just in times of merely wanting a change, we make the choice based on what is right for us in that very moment and that is ALWAYS ok. I’m very conscious of not shaming people for their medication choices.
In saying that, the full picture should be presented to you before you ultimately make that decision. You should be made aware of all the side effects, potential interactions, issues that may correlate with your particular health history, the nutritional deficiencies, all of it. And are you? Are you told about this when you are prescribed the pill? Were you notified that you actually won’t be ovulating while you’re on the pill? Did you know that ovulation is damn important and not just for making a baby? Were you told that the side effects include an increased risk of depression and likely a loss of your sex drive? Did you? I bet the answer is no.. and that is criminal. Health advisors need to be health advisors.
Although people do have reduction in symptoms such as lighter periods and less intense cramping, this is in no way fixing the causative factor and women find more often than not that when the pill is stopped their symptoms return with a vengeance.
So what is the pill actually doing and what kind of side effects are we talking about here?
Grab a cup of tea and sit down.
1. You are suppressing ovulation.
The function of two important hormones (luteinising hormone + follicle stimulating hormone) are suppressed, which results in ovulation not occuring. That’s problematic because ovulation is actually a good indication of what’s going on in your body, such as your thyroid function, hormonal health, whether you are eating enough and meeting your macronutrient requirements, your stress levels and that your insulin is not too high.
Ovulation is required to make steroid hormones that are needed for proper metabolism, healthy bones and a healthy brain. And when you are on the pill you do not ovulate, which means a whole crucial part of your hormonal cycle is suppressed. I’m just going to leave that there.
Ovulation is also how we make progesterone - which is no less important than estrogen. Lara Briden, a women’s health revolutionary and author of The Period Repair Manual explains the importance of ovulation and progesterone as:
“Every monthly dose of progesterone is like a deposit into the bank account of health. It builds bone and metabolic reserve to carry us through all the decades after menopause. (That’s why it’s so important to ovulate while we can during our reproductive decades, and not shut it down with hormonal birth control)”.
2. Nutritional deficiencies
Literature clearly states that the OCP is depleting many important nutrients such as folic acid, vitamin B2 (which is problematic for those predisposed to migraines and one reason why so many people report increased instance of migraines when taking the pill), vitamin B6, B12, Vitamin C and E, magnesium, selenium and zinc. Well shi*t, that’s enough of a problem as it is.
I can pick just one of those nutrients and focus on the detriment on the human body when it isn’t present. Just one. Times that by nine and there is the reality of the OCP. These nutrients on their own, let alone in combination, are responsible for energy levels, nervous system function, collagen production, skin health, immune modulation, metabolism, liver support, cardiovascular health, disease prevention, musculoskeletal health and hormone production. Not that important, right?
It’s also recommended to stay on the OCP until one is ready to conceive, in order to not miss the ‘fertility window’ after cessation of the pill. Oh great, so let’s try and fall pregnant when we are most nutrient depleted. That makes total sense to me. It is well documented that folate is one of the nutrients depleted with the use of the OCP and it is also well documented that folate is required during conception and pregnancy for your baby to develop a healthy brain and to not have neural tube defects. A folate deficiency also increases homocysteine which is then a risk factor for cardiovascular disease. But we’re telling people to fall pregnant while they’re deficient. Have I missed something here? Dietary supplementation should be considered for women who are planning to fall pregnant immediately after stopping birth control and ideally, levels should be assessed BEFORE trying for a baby.
The reduced levels of antioxidants is problematic too (Vitamin C and E). If we know the pill is reducing your bodies ability to protect your cells via depleting some of our antioxidants, then we can expect damage to our cells. Whilst on the pill, it is vital to have an antioxidant rich diet and to work with a practitioner to assess whether supplementation is also required.
3. The pill affects your gut microbiome
This is quite convoluted because the ways in which our gut impacts the rest of our body is quite astronomical but I’ll try and explain this the best way I can. The OCP can disrupt the balance and environment of our normal flora which results in an overgrowth of less ideal bacteria and yeasts. This is a problem for various different reasons.
Firstly, our neurotransmitters such as serotonin and melatonin are synthesised in the gut and these have extremely important roles to play in the outcomes of our mental health.
Secondly, we need a healthy microbiome to metabolise estrogen. Majority of the reasons people are prescribed the OCP is because of cramps, migraines, acne, nausea, vomiting or tender breasts and these are often caused by estrogen dominance. When we’re prescribed the pill for years and years on end which is so often the case, it’s reducing our bodies ability to metabolise estrogen due to its disruption to the microbiome (the place where estrogen is metabolised). We keep taking the pill, we keep worsening the problem, we keep getting symptoms. We stop taking the pill and our symptoms are the worse they’ve ever been. Does this sound familiar?? Now you know why.
Not only that, but your immune system, nervous system and skin health is also heavily dependant on a healthy microbiome and bacterial environment. Prioritising the health of your gut is also one of my number one treatments for all the symptoms that people are put on the pill for, such as PMS. To read more about this, click here.
The pill has also been linked to an increased likelihood of an overgrowth of candida albicans, which manifests as yeast infections. Do you have recurrent thrush?? The pill may be why, especially if you’ve taken it long term.
4. The pill may lower your libido
This one is really sad in my opinion, because a low libido has so many repercussions, not just on physical health. I don’t want to disrespect anyone’s beliefs and this is just my personal opinion, but sex and intimacy is such an important part of a relationship. It’s the ultimate way to express yourself in the most loving and intimate way you know how. Taking a medication that may suppress that is so so awful and can leave a woman questioning their very basic innate physiology. It’s really, really sad. Don’t even get me started on the fact that for many, the pill is prescribed to promote sexual freedom, yet it actually takes that away.
The worst part is that a particular website which I would love to name but I can’t (got myself into a few too many pickles in the past, I told myself to be more subtle from now on ha) suggested that women on the pill should assess their lives and relationships for choices that could be lowering their libidos. What does this message portray?? That women should be questioning themselves?? Nah, don’t let people blame themselves for things out of their control. That’s not cool. Sure, there are multiple factors that affect libido and the OCP is definitely not the only one, but let’s get the facts straight and not blame women for failed relationships. Let’s educate people on all the information, so instead of assuming that not going to the gym on Tuesday is the reason you can’t bring yourself to be intimate with your partner, we can actually view the bigger, more realistic picture.
Basically, birth control reduces the function of your thyroid hormones and lowers testosterone, which is what causes the low libido. Also, because we’re not ovulating (which is when we tend to feel a little more frisky due to a natural spike in testosterone), we miss out on that too. But low thyroid hormone function can also be responsible for weight gain, depression, constipation, dry skin and hair loss.
Literature also reports that the pill may increase your risk of blood clots, stroke and increase your risk of heart attacks. Since we live in a world where our risk factors for cardiovascular complications are already at an all time high, I think it’s time to start being more conscious - don’t you think?
Important take home message: Hormonal imbalances are not too complex to rectify, no matter how dismissive your doctor may seem at finding the root cause. Be persistent. Find someone who wants to help you. There are plenty of fantastic and educated doctors out there. I’m currently working on a resource to connect you with these very doctors so you know exactly where to find them.
You’re on the Oral Contraceptive Pill. You’re meant to be symptom free and have an easier menstruation - but you’re actually feeling tired, nauseous, anxious and have put on weight. Not only that, but this small little pill that was initially prescribed to promote sexual freedom, is actually lowering your libido. This is unfortunately a very common picture for women taking the oral contraceptive pill.
I am not writing this article with the intention of dissing pharmaceutical medicine, or telling you you’re doing it all wrong. This is merely a little reminder that our period is a monthly signal of whether we are in a healthy state or not and as women, we are SO lucky that we are given these signals. Periods are an expression of our health. If we are experiencing severe bloating, cramping, back pain, sore and stiff nipples, headaches, migraines, anxiety or low mood/libido related to our period then we are not in an ideal state of health. When there is something wrong and you are unhealthy in some kind of way, it is your period that brings this to attention. For example, did you know that gluten intolerance can cause irregular periods? The inflammation from gluten interferes with many organs, including the ovaries. This is just a small part of the picture - but when you assess the full picture, you can attempt to treat the symptoms.
The decision here is yours. You can treat the underlying problem, which is likely nutrient deficiencies, systemic inflammation, stress, hormonal imbalance or poor diet/lifestyle factors, or you can take the oral contraceptive pill. The little pill of love that promised pimple free skin, rubber free sex and a symptom free period. But what REALLY is the pill doing? Well, the combined oral contraceptive pill is a tablet that contains ethinyl-estradiol and progesterone. They are strong synthetic pseudo-hormones that suppress ovarian function, which makes it an ‘interesting’ choice when used to ‘fix’ ovarian function. Somehow, we have all been lead to believe that the pill’s active constituents are more powerful than our own innate bodily functions and hormones. But synthetic hormones have not shown that they are more effective at healing our natural body systems, they are not even hormones. In fact, their functions are quite different.
Lara Briden, a biologist and naturopath who has dedicated a lot of time and research into women's health and the oral contraceptive pill wrote a book about (not exclusively) the ingredients and health impacts of the oral contraceptive pill. I've used her book as a resource to summarise the following paragraph on some of the ingredients and their actions.
Let’s look at progesterone. Synthetic progestins (levonorgestrel and drospirenone) abort pregnancies, whereas natural progesterone promotes embryo implantation and pregnancy. Synthetic progestins increase the risk of fatal blood clots, whereas natural progesterone decreases the risk of blood clots. Synthetic progestins cause hair loss, whilst natural progesterone promotes hair growth. Synthetic progestins cause depression (this is the most recently clinically trialled research about the Oral Contraceptive Pill. It’s sad, but true), however natural progesterone improves brain health and cognition. It has been found time and time again that the pill does not regulate your hormones, it switches them off. If this is not the most alarming element of the Oral Contraceptive Pill, then I don’t know what is. Just to recap, your hormones are required for every single properly functioning system in your body.
The World Health Organisation issued a statement raising concern that the pill causes depletion of nutrients and said it needed to be prioritised with clinical importance, however i’m not sure that was the result. The pill has been found to affect the absorption of folic acid, vitamins B1, B2, B6, B12, vitamin C and E and the minerals magnesium, selenium and zinc.
A deficiency in B Vitamins can cause birth defects, poor energy production, anemia, cardiovascular disease, reduced red blood cell formation, fatigue, muscle weakness, anxiety, skin rashes, dementia, dermatitis, memory loss, depression, hallucinations and hair loss.
A deficiency in magnesium can cause muscle spasms and cramps, heart palpitations, anxiety, irregular heart rhythms, fatigue, hypertension (high blood pressure), asthma and osteoporosis.
A deficiency in zinc can cause growth and development problems, hair loss, diarrhea, impotence, eye and skin conditions, loss of appetite, delayed wound healing and mental slowness.
So you're on the pill and you're experiencing these symptoms. What do you do? Firstly, assess whether the benefit of being on the pill for you outweighs the negatives, and then go and see a practitioner that understands the link between symptoms, medications and nutrients. There are specific doses of micronutrients that I use to treat heavy periods, menstrual migraines, breast tenderness, bloating, anxiety, PMS, cramping and/or back pain. There are also specific nutrients for both nutrient deficiencies caused by the Oral Contraceptive Pill, and hormone dysfunction. We tend to think that period pain is just part and parcel of menstruation - but this is so very untrue.
Like most things, we can always counteract or at the very least support what we are doing to our body with nutrients. This is not about coming off the pill. Every woman who is on the pill has a valid reason for why they believe they should be on it and that is absolutely ok. I also do not deny the pill's need in some particular medical conditions, however I feel even this is a poorly understood topic that needs revision.
What is not ok, is blindly being prescribed the pill with no knowledge on what it is doing to your body, what the ingredients are, and what they are doing to your natural hormones. Once we know, we can choose whether it is still worth it for us and if it is, that’s absolutely fine. Know what you’re putting inside your body. I end almost all my articles with this comment but it’s because it runs true against everything that I write. No-one should judge you for your choices, not your nutritionist, not your doctor, not your friends. Once you know what you are putting inside your body, you are within your right to do whatever it is you please. Only you know best about what is worth it or not. But make all your choices informed choices. It’s the most intelligent thing you can ever do.